How much rates vary
Facilitymedian $2,818 · 10th to 90th $1,000 to $7,244Professionalmedian $741 · 10th to 90th $562 to $1,820
Distribution of negotiated rates across all payers (price axis is log-scale). Need provider-level prices or 24+ months of history? Contact us.
Rates by insurance carrier
| Insurance Carrier | Facility/Professional | Modifier | Typical Low | Median | Typical High |
|---|---|---|---|---|---|
Aetna Setting Facility Modifier None Typical Low $1,698.24 Median $4,897.79 Typical High $7,762.47 | Facility | None | $1,698.24 | $4,897.79 | $7,762.47 |
Aetna Setting Professional Modifier None Typical Low $512.86 Median $602.56 Typical High $707.95 | Professional | None | $512.86 | $602.56 | $707.95 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,318.26 Median $3,467.37 Typical High $7,079.46 | Facility | None | $1,318.26 | $3,467.37 | $7,079.46 |
Anthem BCBS Setting Professional Modifier None Typical Low $616.60 Median $741.31 Typical High $1,071.52 | Professional | None | $616.60 | $741.31 | $1,071.52 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $912.01 Median $1,096.48 Typical High $1,621.81 | Professional | 50 · Both sides | $912.01 | $1,096.48 | $1,621.81 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $97.72 Median $117.49 Typical High $169.82 | Professional | 80 · Assistant surgeon | $97.72 | $117.49 | $169.82 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $85.11 Median $102.33 Typical High $151.36 | Professional | AS · PA/NP assist | $85.11 | $102.33 | $151.36 |
BCBS Kansas City Setting Professional Modifier None Typical Low $562.34 Median $602.56 Typical High $812.83 | Professional | None | $562.34 | $602.56 | $812.83 |
Cigna Setting Facility Modifier None Typical Low $645.65 Median $1,122.02 Typical High $2,691.53 | Facility | None | $645.65 | $1,122.02 | $2,691.53 |
Cigna Setting Professional Modifier None Typical Low $501.19 Median $630.96 Typical High $1,230.27 | Professional | None | $501.19 | $630.96 | $1,230.27 |
Medica Setting Facility Modifier None Typical Low $870.96 Median $2,754.23 Typical High $26,302.68 | Facility | None | $870.96 | $2,754.23 | $26,302.68 |
Medica Setting Professional Modifier None Typical Low $602.56 Median $1,071.52 Typical High $5,370.32 | Professional | None | $602.56 | $1,071.52 | $5,370.32 |
United Setting Facility Modifier None Typical Low $1,000.00 Median $2,818.38 Typical High $5,370.32 | Facility | None | $1,000.00 | $2,818.38 | $5,370.32 |
United Setting Professional Modifier None Typical Low $537.03 Median $776.25 Typical High $1,202.26 | Professional | None | $537.03 | $776.25 | $1,202.26 |
6 more rates with less common billing modifiers
A modifier changes what was billed, for example a reduced or repeated service. Each of these modifiers carries under 10% of the published rates for this code. Modifier combinations, and modifiers with fewer than 30 rates for a carrier, are not listed.
| Insurance Carrier | Facility/Professional | Modifier | Typical Low | Median | Typical High |
|---|---|---|---|---|---|
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $251.19 Median $302.00 Typical High $331.13 | Professional | 52 · Reduced service | $251.19 | $302.00 | $331.13 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $102.33 Median $123.03 Typical High $134.90 | Professional | 53 · Discontinued | $102.33 | $123.03 | $134.90 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $380.19 Median $457.09 Typical High $501.19 | Professional | 54 · Surgery only | $380.19 | $457.09 | $501.19 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $75.86 Median $91.20 Typical High $100.00 | Professional | 55 · Aftercare only | $75.86 | $91.20 | $100.00 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $51.29 Median $60.26 Typical High $67.61 | Professional | 56 · Pre-op care only | $51.29 | $60.26 | $67.61 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $354.81 Median $426.58 Typical High $467.74 | Professional | 78 · Unplanned return to OR | $354.81 | $426.58 | $467.74 |
Where Missouri sits
The same service costs 7.4 times more in Alaska than in Texas. Every bar is a state, most expensive first. Touch or drag across it to read any state, then open that state for its carriers and full range.
Missouri· 31st of 51
$813
AK $2,455TX $331
Median negotiated rate in each state, from every insurer that publishes one. States where no insurer publishes a rate for this service are not shown.